Presentation Description: Children and adolescents with cancer may present with challenging behavior that can interfere with medical care, adherence to treatment, and quality of life. There are a wide variety of strategies that may decrease distress, allow for optimal medical care, and enhance quality of life for both children and their families.
This presentation reviewed a range of multi-disciplinary interventions including psycho-education, procedural support, cognitive behavioral therapy, and parent problem-solving therapy, as well as psychopharmacology approaches to behavioural problems.
Speaker:
Anna C. Muriel, MD, MPH
Chief, Division of Pediatirc Psychosocial Oncology,
Department of Psychosocial Oncology and Palliative Care
Dana Farber Cancer Institute, Boston MA
Presentation Description: Survivors of CNS impacting cancers diagnosed in childhood are at significant risk for cognitive impairments. As survival rates improve, efforts to optimize cognitive outcomes take on added importance. Historically, there have been few empirically supported interventions for cancer survivors. Findings from pharmacologic interventions, largely using methylphenidate, have revealed an intervention that is safe and efficacious. However, there remain children for whom stimulant medications are not a viable option due to medical contraindication, parental preference or poor medication response.
Findings from nonpharmacologic, therapist-delivered interventions offer initial encouragement, particularly for improving academic skills; yet, time and financial requirements are high for relatively modest benefits, and individuals must reside in close proximity to providers. Computerized cognitive training offers added advantages of remote administration, decreased personnel resources and standardized implementation. Studies have demonstrated the feasibility, acceptability and efficacy of this approach, with neuroimaging findings suggestive of training-related neuroplasticity. Generalization of benefits to non-trained skills and maintenance of benefits over time are being investigated. Future directions include the use of genetics and neuroimaging to identify cognitive risk early in treatment as well as individualize intervention approaches.
This presentation provided an overview of pharmacologic and nonpharmacologic interventions for cognitive late effects experienced by childhood cancer survivors, including novel interventions currently under investigation.
Speaker: Heather M. Conklin, PhD
Chief, Neuropsychology Section
Associate Member, Department of Psychology
St. Jude Children’s Research Hospital, Memphis, TN
Presentation Description: This session provided a “quick hit” review of early warning signs in paediatric sepsis. Essential concepts for identification, intervention and management were highlighted in a case based discussion. Clinical tools related to paediatric early warning signs (PEWS) and sepsis were introduced.
Speaker: Julie Watson, MSN, NP-Pediatrics Nurse Practitioner
Hospital for Sick Children, Toronto, ON
Presentation Description: Weight loss is a common side-effect of cancer and its treatment. This session discussed different assessment methods used to determine when and how to intervene to achieve weight gain and growth in the pediatric cancer patient. Options for providing nutrition support were discussed as well as the potential consequences of continued weight loss in this patient population.
Speakers: Mary A. Barron, MSc, RD
Clinical Dietitian, Department of Haematology/Oncology
Hospital for Sick Children, Toronto
Charmaine van Schaik, BSc, MSc, MD, FRCPC
Chief of Pediatrics; Medical Director, POGO Satellite Clinic
Southlake Regional Health Centre, Newmarket, ON
Lecturer, University of Toronto, Dept. of Pediatrics, Toronto, ON
Presentation Description: Although the majority of AYA survivors of childhood cancers adjust quite well, subsets of survivors may experience a number of psychological, social and/or family concerns. In addition, AYA survivors are at risk for poor adherence to survivorship follow-up treatment recommendations. These two presentations included information about general adaptation and distress, and models useful for identifying, understanding and treating AYA survivors who could benefit from psychosocial interventions.
Workshop Facilitators:
Anne E. Kazak, PhD, ABPP
Chief, Section of Behavioural Oncology
Editor-in-Chief, Health Psychology
Director, Centre for Pediatric Traumatic Stress, The Children’s Hospital of Philadelphia
Professor, Department of Pediatrics, University of Pennsylvania, Philadelphia
Christopher J. Recklitis, PhD,l MPH
Clinical Psychologist, Dana-Farber Cancer Institute
Assistant Professor of Pediatrics, Harvard Medical School, Boston
